Complex dissociation following maternal suicide attempt in a 17-year-old female: a case report

TL;DR

A 17-year-old girl developed rare dissociative symptoms after witnessing her mother's suicide attempt, highlighting the importance of trauma in mental health.

Contribution

This case report presents a rare combination of dissociative amnesia, stupor, and conversion disorder following maternal suicide exposure.

Findings

The patient exhibited generalized amnesia, dissociative stupor, and conversion disorder following psychological trauma.

Supportive psychotherapy resolved symptoms without medication, emphasizing the role of trauma in dissociative disorders.

Thorough psychological assessment was critical for diagnosis after ruling out organic causes.

Abstract

Dissociative disorders involve disruptions in memory, identity, sensory awareness, and motor control, often triggered by psychological distress. Dissociative amnesia may appear as either retrograde or anterograde memory loss, and dissociative stupor as well as conversion disorder are also considered part of the dissociative disorders spectrum. Cases presenting with generalized amnesia (both retrograde and anterograde), dissociative stupor, and conversion disorder are rare. Here, I report a unique case of a 17-year-old female exhibiting this combination of symptoms following her mother’s depressive relapse.

A 17-year-old Japanese female developed complete amnesia 3 weeks before presentation. Her mother, diagnosed with depression, had been hospitalized. The patient had a history of exposure to domestic violence and had taken on a caregiving role for her mother. She initially experienced episodic stupor, involuntary eye deviation, and transient unconsciousness, followed by generalized amnesia affecting personal, semantic, and procedural memory. Neurological and medical evaluations ruled out organic causes, leading to a psychiatric referral. As amnesia improved, she recalled witnessing her mother’s suicide attempt 2 years prior. Her symptoms were diagnosed as dissociative amnesia, dissociative stupor, and conversion disorder, attributed to psychological distress. Supportive psychotherapy, psychoeducation, and environmental stabilization led to symptom resolution without medication.

This case highlights a rare presentation of dissociative amnesia with stupor and conversion disorder. The diagnosis was initially challenging owing to amnesia masking the stressor. Careful exclusion of organic causes and thorough psychological assessment were key. This case underscores the importance of identifying underlying trauma in complex dissociative presentations.